Here's what I found on BMS. I sight each source at the fore of each excerpt.
http://www.webmd.com/pain-management/video/burning-mouth-syndrome
glitch in CNS, nerves that control taste and smell
Causes
By Mayo Clinic staff
The cause of burning mouth syndrome can be classified as either primary or secondary.
Primary burning mouth syndrome
When the cause of burning mouth syndrome isn't known, the condition is called primary or idiopathic burning mouth syndrome. Some research suggests that primary burning mouth syndrome is related to problems with taste and sensory nerves of the peripheral or central nervous system.
Evidence of chorda tympani dysfunction in patients with burning mouth syndrome
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Eli Eliav, DMD, PhD,
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Batya Kamran, DMD,
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Rachel Schaham, DMD,
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Rakefet Czerninski, DMD,
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Richard H. Gracely, PhD and
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Rafael Benoliel, BDS
Abstract
Background. More than two-thirds of patients with burning mouth syndrome (BMS) have altered taste sensation. The authors conducted a study to assess chorda tympani and trigeminal nerve function in these patients.
Methods. The study was composed of 48 patients; 22 were diagnosed as having BMS, 14 had burning symptoms related to other diseases and were diagnosed as having secondary burning mouth syndrome (SBMS), and 12 were healthy volunteers. The authors evaluated the electrical detection thresholds of the infraorbital and mental nerves and the electrical taste and electrical detection/tingling thresholds in the anterior two-thirds of the tongue for all patients. Electrical taste threshold is thought to be dictated by chorda tympani nerve function while electrical detection/tingling thresholds are regulated by trigeminal nerve function.
Results. The mean electrical taste/tingling detection thresholds ratio and the taste detection thresholds were significantly higher in patients with BMS than in patients with SBMS and in control subjects, indicating chorda tympani nerve dysfunction. Eighteen (82 percent) of the 22 patients with BMS demonstrated chorda tympani dysfunction (13 unilateral and five bilateral).
Conclusions. Chorda tympani hypofunction may play an important role in BMS pathology. Unilateral hypofunction may be sufficient to produce generalized burning sensation exceeding the affected nerve area.
Clinical Implications. Elevated taste detection threshold levels determined via electrogustatory testing and an elevated taste/tingling detection thresholds ratio may assist clinicians in the diagnosis of BMS. More studies are needed to validate these findings.
Neurogenic Mechanisms in Burning Mouth Syndrome (BMS17)
This study has been completed.
First Received on April 2, 2009. Last Updated on February 22, 2011 History of Changes
Sponsor: |
University of Copenhagen |
Information provided by: |
University of Copenhagen |
ClinicalTrials.gov Identifier: |
NCT00875537 |
Purpose
Burning mouth syndrome (BMS) is characterized by a bilateral burning sensation in the anterior tongue, hard palate and lips in the absence of any clinical or laboratory findings. The term syndrome implicates the simultaneous presence of oral dryness (xerostomia) and altered taste (dysgeusia) in addition to the burning sensation in the oral mucosa. BMS is most often seen in women and is more frequent during menopause. The etiology and pathogenesis are still unclear but recent studies suggest that BMS is a neuropathic pain condition.
The objectives of the study are:
- To clarify potential neurogenic mechanisms behind BMS using immunohistochemistry (IH) to characterize the localization and distribution of peripheral nerve fibres, neuropeptides like substance P, calcitonin gene-related peptide, nerve growth factor, nerve growth factor receptor, PGP 9.5 neuronal marker and TRPV1 as well as inflammatory/structural changes.
- To perform a randomized double blind cross-over intervention study to examine the efficacy and safety of topical application of capsaicin oral gel (on the tongue) to relieve the burning sensation in patients with BMS.
Study Type: |
Interventional |
Study Design: |
Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
Official Title: |
Neurogenic Mechanisms in Burning Mouth Syndrome With Focus on Localization and Desensibilization of Vanilloid Receptor TRPV1 |
Resource links provided by NLM:
MedlinePlus related topics: Burns
Drug Information available for: Capsaicin
U.S. FDA Resources
Further study details as provided by University of Copenhagen:
Primary Outcome Measures:
- Primary outcome: To evaluate the efficacy and safety of topical application of capsaicin oral gel (using to different concentrations) to relieve the burning sensation in patients with BMS and alleviate BMS related symptoms. [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
Secondary Outcome Measures:
- To characterize the localization and distribution of peripheral nerve fibres, neuropeptides like substance P, calcitonin gene-related peptide, NGF, NGF-R, PGP 9.5 neuronal marker and TRPV1 as well as inflammatory/structural changes. [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Estimated Enrollment: |
26 |
Study Start Date: |
January 2009 |
Study Completion Date: |
June 2010 |
Primary Completion Date: |
April 2010 (Final data collection date for primary outcome measure) |
Arms |
Assigned Interventions |
Active Comparator: Capsaicin oral gel 0.01% |
Other: Capsaicin oral gel 0.01%
Application 3 times daily for 14 days on the tongue, followed by 14 days wash-out
Other Name: Capsicum, extract from chilipepper
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Active Comparator: Capsaicin oral gel 0.025% |
Other: Capsaicin oral gel 0.025%
Application 3 times daily for 14 days on the tongue, followed by 14 days wash-out
Other Name: Capsicum, extract from chilipepper
|
Detailed Description:
Data which support the hypothesis that BMS is a neuropathic pain condition include amongst others a recent clinically controlled study that has shown up-regulation of TRPV1-positive nerve fibres in tongue mucosa in patients with BMS. The vanilloid receptor-1 (TRPV1) is a voltage-dependent cation channel expressed by the unmyelinated C-nociceptive nerve fibres and the receptor may be activated by capsaicin (from chili peppers), heat and H+. Capsaicin binds to the TRPV1 receptor causing depolarization of the C-nociceptors. Prolonged activation of these neurons by capsaicin depletes pre-synaptic substance P and makes them unable to report pain.
Eligibility
Ages Eligible for Study: |
18 Years to 70 Years |
Genders Eligible for Study: |
Female |
Accepts Healthy Volunteers: |
Yes |
Criteria
Inclusion Criteria:
- non-smoking female patients with burning mouth syndrome (n=26)
- healthy aged-matched control group (n=10)
Exclusion Criteria:
- pregnancy and lactation (inclusion requires negative pregnancy test)
- women who do not use safe anticonception
- patients with know allergy/hypersensitivity to capsicum and other capsaicinoid-containing products
- Active infection which requires antibiotic treatment
- use of mouthrinse. The use of these is stopped 14 days before inclusion
- patients who are able to give informed consent due to physical or mental disabilities
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00875537
Locations
Denmark |
Department of Odontology, Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology & Anatomy |
|
Copenhagen, Denmark, 2200 |
Sponsors and Collaborators
University of Copenhagen
More Information
No publications provided
Responsible Party: |
Anne Marie Lynge Pedersen/associate professor, PhD, DDS, Department of Odontology, Faculty of Health Sciences, University of Copenhagen |
ClinicalTrials.gov Identifier: |
NCT00875537 History of Changes |
Other Study ID Numbers: |
H-A-2008-118 |
Study First Received: |
April 2, 2009 |
Last Updated: |
February 22, 2011 |
Health Authority: |
Denmark: Danish Medicines Agency Denmark: Ethics Committee Denmark: Danish Dataprotection Agency Denmark: The Regional Committee on Biomedical Research Ethics |
Keywords provided by University of Copenhagen:
Burning mouth syndrome neuropathy inflammation |
tongue mucosa tongue innervation dysgeusia |
Additional relevant MeSH terms:
Burning Mouth Syndrome Burns Mouth Diseases Stomatognathic Diseases Wounds and Injuries Capsaicin Sensory System Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Antipruritics Dermatologic Agents Therapeutic Uses |
It is old info that BMS is psychological in nature and Mayo Clinic has changed their info to show that.
HUGS, Julie